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Washington rates for HCPCS 99213

Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.

Facilitymedian $95 · 10th–90th $49$2400%5%10%10th90th$95Professionalmedian $91 · 10th–90th $50$2290%10%10th90th$91$1.0$5.0$20.0$100.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $102.33 / $213.80
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$57.54 / $245.47 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $89.13 / $223.87
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$51.29 / $93.33 / $245.47
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$38.02 / $257.04 / $269.15
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $100.00 / $173.78
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $100.00 / $177.83
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $125.89 / $194.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $117.49 / $147.91
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Cigna
Facility/Professional
Facility
Modifier
62
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
Cigna
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$10.23 / $10.23 / $10.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $95.50 / $199.53
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $77.62 / $169.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $75.86 / $162.18
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $45.71 / $100.00
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $151.36 / $181.97
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $117.49 / $223.87
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $125.89 / $190.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $43.65 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $91.20 / $162.18
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$60.26 / $89.13 / $151.36
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $97.72 / $138.04